Movement Disorders Flashcards
What is the MC movement disorder?
Tremor
What is the MC neurologic cause of postural or action tremor?
Essential Tremor
Essential Tremor treatment
Long Acting Propanolol
Propanolol SE’s
- Lightheadedness
- Fatigue
- Impotence
- Bradycardia
Who should you caution with propranolol?
- Heart block
- Asthma
- Type 1 diabetes mellitus
List the anticonvulsant used for treatment of essential tremors
- Primidone
- Topiramate
- Gabapentin
What is the max dose where there is no benefit beyond that in Primidone
750 mg/daily
Main SE’s of Primidone
Sedation
Topiramte MOA
Enhances GABA activity
Blocks voltage-gated sodium channels
Toprimate ADEs
Concentration difficulty
Gabapentin ADEs
- Gait unsteadiness
2. “Brain fog”-interferes with memory
What does Botulinum toxin type A injection provide MODEST benefit in?
Limb tremor
What Botulinum toxin type A injection POSSIBLY reduce?
- Head tremor
- Voice tremor
* Limited data
ADEs of Botulinum toxin type A in treatment of voice tremor
- Breathlessness
- Hoarseness
- Swallowing difficulty
Benzodiazepines MOA
Enhances GABA activity
Why are Benzodiazepines second-line choice in treating essential tremors?
Dependence issues
What part of the brain does Huntington’s dz affect?
Basal Ganglia
How would you treat chorea in huxngtingtons?
Central Monoamine Depleting Agents
List the Central Monoamine Depleting Agents
- Tetrabenazine
2. Deutetrabenazine
SE’s of Tetrabenazineand Deutetrabenazine
Depression
Haloperidol MOA
Blocks Dopamine
Haloperidol clinical application
- Tourette’s Syndrome
2. Huntington’s chorea
Haloperidol SE’s
Extrapyramidal dysfunction
–>Get Parkinson’s like movements D/T this
What would you use atypical antipsychotics in the treatment of?
- Tourettes
2. Schizophrenia: Improves both positive and negative sx’s